Résumé
Background: Maternal mortality is a vital index of the effectiveness of obstetric services prevailing in a country. The key to progress of a country lies in reducing its maternal morbidity and mortality, hence to give a better assessment of the problem a retrospective study on maternal mortality was carried out. An objective of the study was to find the cause and epidemiological factors for maternal mortality in a tertiary care hospital in western Maharashtra from January 2018 to August 2019.Methods: A retrospective, descriptive study done at tertiary care hospital in western Maharashtra from January 2018 to august 2019. Data was collected from medical records department and the study was conducted by reviewing the records of maternal death and scrutinizing for various aspects likely to be related to maternal death such as age, locality of residence, antenatal care, admission death time interval and cause of death.Results: during the study period 63 maternal deaths occurred and 75302 live births, Maternal Mortality Ratio were 83.66 per 1 lakh live birth. 46% of maternal deaths were in age group of 21-25 years, 87% of patients belonged to rural area, 74% belonged to lower socioeconomic status. 43% were unregistered patients, 43% had vaginal delivery, 73% had no free transportation, 68% were referred patients, 60% were referred from private hospitals, 48% of maternal death occurred <24 hours, 73% of maternal death were due to direct cause, 28% of maternal deaths were due to pre-eclampsia and its complications, 15.8% due to sepsis and 12.6% due to Postpartum hemorrhage.Conclusions: Being a tertiary care hospital, where patients are referred from periphery maternal mortality was found to be on higher side. Proper implementation of government policies with community participation along with strengthening of First Referral Unit (FRU) and Primary Health Centres can help to reduce maternal mortality.
Résumé
Background: Availability of emergency obstetric care (EmOC) is one of interventions to reduce maternal and newborn deaths. The health system fails when effective and affordable health interventions do not reach the population, when Poor infrastructure, drugs and equipment are lacking, and qualified human resources are scarce. The objective of the present study was to assess the availability of EmOC infrastructure in first referral units (FRUs) of Surguja division, Chhattisgarh.Methods: A cross sectional study was designated with 13 FRUs of Surguja division. A semi structured, closed-ended questionnaires was observed on the basis of check list, reviewing record, and interview by available staff.Results: FRUs of Surguja division for physical infrastructure scored 68.5%, for essential medicine 69.2%, for equipments 50.7%, for instruments 45.3% and for availability of blood 34.6%, for health man power category of specialist score was 25.7% but for supportive staff 65.4%.Conclusions: Our study revealed three existing bottlenecks in the healthcare delivery system as inadequate civil infrastructure, short fall of specialists as well as inadequate supplies of drugs and equipment, hampering the function of facility.
Résumé
Background: Indoor client satisfaction is a landmark parameter to assess the functioning of the First Referral Unit, being established by the Govt. of India, under Child Survival and Safe Motherhood (CSSM) programme in year 1992. At present, under the flagship of National health mission (NHM), CSSM is expected to reduce the burden of high maternal mortality in India and scope of further reduction from current levels to ensure a safe motherhood and subsequently childhood to achieve the goal of “Health for All”. Regarding this context, some of the Primary and majority of Community Health Centers were upgraded to First Referral Units (FRUs) which were specifically equipped to handle emergency obstetric cases. Intensified efforts are being continued to strengthen these FRUs under national health mission program extensively by addressing the needs of the patient’s especially indoor patients attending FRUs. Methods: Patients/clients availing indoor services; sample of 60 clients was chosen for questionnaire. Questions were asked to them to assess level of satisfaction regarding availing various indoor services and their responses were graded as poor-1, fair-2 and good-3. Results: Assessment of the functioning of the FRUs have indicated that overall satisfaction level among indoor clients is approximately 50%, which can be improved further by improving delivery of services. Conclusions: We conclude that in order to run FRU smoothly, priority should be given to health care needs of the clients.
Résumé
To study the maternal mortality and common complication leading to maternal death over a period of 10yrs from Jan 1999 to Dec. 2009.A retrospective study of hospital records and death summaries of all maternal deaths over 10 yr periods was carried out. MMR of 270.33/1,00,000 live births was observed over a period of 10 yrs. post partum hemorrhage was the leading direct cause and anemia the leading indirect cause. Most women died within 24 hrs of admission. The age group of 20-30 yrs was crucial. Most deaths were in unbooked cases transferred from outside. Hemorrhage and PIH are major causes of death. Most maternal deaths are one preventable by quality health education of women & adequate care to the mothers at all levels district health system.